Hematopoietic stem cells are collected and transplanted into a patient to replace diseased or damaged marrow. Concerns about pain are common among potential donors, but the experience is often much less uncomfortable than widely believed. The donation process is generally safe, and the exact level of discomfort depends significantly on the collection method used.
Two Primary Methods of Stem Cell Donation
Stem cells are collected using two methods: Peripheral Blood Stem Cell (PBSC) donation and Bone Marrow (BM) donation. The choice of method is determined by the patient’s medical needs, but PBSC is used in approximately 90% of all cases today. PBSC is similar to a blood donation, while BM donation is a surgical procedure performed in a hospital setting.
The Peripheral Blood Stem Cell Donation Experience
PBSC donation requires a few days of preparation before collection begins. Donors receive daily injections of Filgrastim (G-CSF) for four to five days. This drug rapidly increases the number of stem cells in the bone marrow, forcing them into the circulating bloodstream for collection.
The primary discomfort comes from the Filgrastim injections, not the collection itself. Common side effects include a dull ache in the bones, often felt in the pelvis or legs, along with flu-like symptoms such as headaches and fatigue. This musculoskeletal pain is a direct result of the drug stimulating the bone marrow to work overtime. These effects typically resolve within 48 hours of the final dose.
The actual collection is performed through apheresis, a non-surgical process comparable to donating platelets. Blood is removed from one arm, filtered by a machine to collect stem cells, and returned to the other arm. Donors may experience a tingling sensation around the mouth, fingers, or toes during the procedure. This is caused by the anticoagulant citrate temporarily binding to calcium in the donor’s blood.
The Bone Marrow Donation Experience
Bone marrow donation is a surgical procedure performed in an operating room under general or regional anesthesia. Since the donor is fully sedated, they feel no pain during the collection itself. The procedure involves using sterile needles to withdraw liquid marrow directly from the back of the pelvic bones (iliac crest).
The primary discomfort occurs after the procedure, once the anesthesia wears off. Donors experience soreness, bruising, and a dull ache in the lower back or hip area where the marrow was withdrawn. This pain is managed with oral pain medication, and most donors describe the feeling as similar to having fallen hard on their tailbone.
The soreness generally lasts for a few days, though recovery time is highly individual. While some donors recover within a few days, others may experience residual discomfort for up to four weeks. The medical team monitors the donor closely and ensures adequate pain relief is provided.
Post-Donation Recovery and Temporary Side Effects
Regardless of the method used, donors experience some temporary side effects after the procedure. Fatigue is common, often lasting for a few days to a week as the body recovers. Bruising at the needle insertion sites is also common, whether from the apheresis lines or the collection sites.
The body begins replacing the donated stem cells immediately, and blood counts return to normal within a few weeks. Donors are advised to avoid strenuous physical activity briefly. They generally return to normal routines, including work, within a few days to a week. Scientific data confirms that donating stem cells poses no known long-term health risks, as the body quickly restores the supply.